Smallpox and the Right to Know

In October of last year, all Americans got a crash course in bioterrorism. Anthrax-laced letters made postal workers, members of the media, and others sick. Seventeen people fell ill and five died.

As frightening as the threat from anthrax was, there loomed on the bioterrorism horizon an even more terrifying threat: smallpox. Although smallpox has been eradicated world-wide, we learned that there were two laboratories that had preserved the virus one in Atlanta, Georgia, the other in Russia. Smallpox samples at the latter location were a concern. Could terrorists have access to those samples? Could terrorists introduce smallpox into our highly vulnerable society? Routine vaccination for smallpox stopped in the U.S. in l972. Would we have enough smallpox vaccinations available if needed?

The party line from the government in October, 200l was that the nation had some l5 million doses of smallpox vaccine. That was it. This was not a very comforting fact to present to a jittery nation, and when government officials somberly told us that efforts were underway to make more vaccine "in the next couple of years," many of us cringed. Wouldn't that leave us vulnerable to terrorists? Some optimism warranted, as it turned out was expressed about the possibility of diluting the l5 million doses while maintaining their efficacy, but even the most favorable predictions were that the "loaves and fishes" approach to the l5 million doses would yield only about 75 million innoculations, far from enough for the entire U.S. population.

But in just the past few weeks we learned that back in October, while all of us were fretting about our potential vulnerability to smallpox, the United States government had information that it chose not to share with us. In October, the French pharmaceutical company Aventis Pasteur reminded the U.S. government that it had nearly 90 million doses of smallpox vaccine in a freezer in Swiftwater, Pennsylvania.

Why weren't the American people told of the existence of this supply as soon as the concern about smallpox bioterrorism became a reality?

In their infinite wisdom, apparently, the government and the pharmaceutical company decided that we should not know about this incredible "find" until they had determined the vaccine was still effective. Said Richard J. Markham, Chief Executive of Aventis' American operations, "none of us wanted to get people's hopes up and then find out that we could not use it."

How would one characterize such a decision to withhold information on these grounds? Patronizing is one way to describe it. Does the government consider us so immature that we cannot grasp two bits of information at the same time: that a huge supply of the vaccine existed and that we did not yet know whether it still worked?

Knowledge of the existence of this supply of smallpox vaccine would have dramatically changed the nature of the debate on the issue last fall, even if we were not sure at that time whether the vaccine's efficacy was intact after forty years. Indeed, one might speculate that a widespread knowledge of the potentially effective vaccine might have been a further deterrent to terrorists contemplating a smallpox attack. It has now been confirmed that the vaccine not only works but can be diluted to create more doses, as is being done with the government's smaller supply.

Absent some clear national security justification for withholding information, the government should tell us what it knows. Instead of worrying about how information will affect our emotional state, they should stop coddling us. In a free society, critical information that has far-reaching implications for the public's health should not be withheld, even if that information is incomplete.

Dr. Whelan, President of ACSH, holds doctoral and master's degrees in public health.

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Responses:

April 5, 2002

As to the smallpox vaccine commentary, I think Doctor Whelan is off-base on this one. I would certainly have done just what "the government" did: Don't go to the public unless we know the stuff is still good.

Leave the claims of "cover-up" to the eco-terrorists. It's unbecoming.

Best wishes.

John M. R. Bruner, M.D. Groton, Massachusetts


April 5, 2002

Hear, hear!

As adults, we can make up our own minds.

PWBurrets


April 8, 2002

1. Under the National Security Act, the people in this country have no right to know anything. If you want to know more, I suggest you get to know this act.

2. This may be a stupid question but: How long will the watered-down vaccine last? Will it still be useful if needed in five years? Will enough new vaccine be created for everyone now or will they just make enough to fill the gap between what they have and what is needed? Several years back, people were going around trying to steal money from people by scaring them about their children not being protected from smallpox. At the time, we were informed by the press that the only place in the world that had the smallpox vaccine was somewhere in Sweden and they were contemplating destroying that supply so something like this could not happen. Now we're being told two places have it and Sweden isn't even one of them. Does anyone even know whether some other country has any stored and forgotten vaccine somewhere from forty years ago? Odds are that some countries kept the vaccine somewhere just in case another outbreak or new case turned up. Personally, I think there is more vaccine than is known about and there will not be another outbreak unless this government wants another outbreak to occur.

hglover1